Surgical Management of Lymphocele Excision with Novel Fish Skin Graft for Prevention of Seroma Formation

Introduction: A lymphocele is an atypical collection of lymphatic fluid that develops into anatomic compartments.  Due to the location and size of these lymphoceles, surgical intervention is indicated in such cases to provide symptoms relief of pain and debilitation. Standard treatment for the condition is lymphocele drainage under CT or ultrasound guidance. Fish skin graft (FSG) is a unique biologic scaffold resembling the dermal extracellular matrix. FSG is rich in Omega3 that anti-inflammatory, promotes cellular ingrowth, neovascularization and aids tissue infill and remodel. We hypothesize that FSG, being rich in Omega 3 and anti-inflammatory properties can be used as part of the surgical intervention for excision of  lymphocele to prevent seroma formation and possibly increased scar tissue formation leading to closing lymphatic channels as well as aiding in tissue formation, vascularization and cellular ingrowth.Methods:A pilot study was conducted on 2 patients with lymphoceles. One to the thigh and one to the foot. Elliptical excision was made both anterior and posterior to the mass. Brought all the way down to the area of muscle and removed the entire lymphocele. FSG applied and closed primarily. Drains inserted. Results:Complete healing achieved in both cases without complications. Application of FSG resulted in an absence of seroma formation that led to successful healing time with no infections. Patients also noticed scar reduction and less pain.Discussion: Application of FSG resulted in an absence of seroma formation that led to fast and successful healing time. Patients also noticed scar reduction and less pain.References: